Capanegro James, Quinn Erina, Arndt Mary, Sherard Douglass
Lake Erie college of Osteopathic Medicine Bradenton campus, Bradenton , Florida.
McClow, Clark and Berk Radiologists, Jacksonville, Florida.
Radiol Case Rep. 2021 May 25;16(7):1878-1881. doi: 10.1016/j.radcr.2021.04.045. eCollection 2021 Jul.
The authors report a case of a 75-year-old male with pulmonary embolism (PE) successfully treated using the INARI FlowTriever System, a mechanical thrombectomy device. Imaging confirmed deep vein thrombosis and PE presented after two days of left lower extremity (LLE) pain and dyspnea on exertion with history of peripheral vascular disease, coronary artery disease, insulin dependent diabetes mellitus, hyperlipidemia and LLE percutaneous coronary intervention with coronary stent placement. PE treatment with single session clot burden reduction resulted in immediate improvement in oxygenation and echocardiogram confirmed relief of right heart strain. The patient's immediate hemodynamic improvement without thrombolytic therapy, which can take hours for morbidity reduction, supports the expansion of the use of thrombectomy devices for the treatment of submassive symptomatic PE in clinical practice, with further research indicated.
作者报告了一例75岁男性肺栓塞(PE)患者,使用机械血栓清除装置INARI FlowTriever系统成功治疗。影像学检查证实为深静脉血栓形成,患者在出现左下肢(LLE)疼痛和劳力性呼吸困难两天后出现PE,既往有外周血管疾病、冠状动脉疾病、胰岛素依赖型糖尿病、高脂血症病史,且曾接受LLE经皮冠状动脉介入治疗并植入冠状动脉支架。单次治疗减轻血栓负荷的PE治疗使氧合立即得到改善,超声心动图证实右心劳损缓解。患者未接受溶栓治疗(溶栓治疗可能需要数小时才能降低发病率)却立即出现血流动力学改善,这支持在临床实践中扩大使用血栓清除装置治疗亚大块症状性PE,不过仍需进一步研究。